Assessment of potentially unnecessary antibiotic use for suspected urinary tract infections in nursing homes using a simplified algorithm.
Carl Llor, Jonas Olsen, Jesper Lykkegaard, Marilena Anastasaki, Jette Nygaard Jensen, Jens S��ndergaard, Valeria Antsupova, Davorina Petek, Malene Plejdrup Hansen, Marie Theut, Christos Lions, Lina Jaruseviciene, Ruta Radzeviciene, Andr��s B��lint, Helena Glasova, Jozef Glasa, Nina Sodja, Ana Moragas, Ramon Monf��, Ana Garc��a-Sangen��s, Anna Kowalczyk, Georg Ruppe, Laura Vallejo-Torres, Marina Elistratova, Beatriz Gonz��lez L��pez-Valc��rcel, Greta Tsoulchai
Author Information
Carl Llor: Primary Care Research Institute Jordi Gol (IDIAP), Barcelona, Spain.
Jonas Olsen: Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Esbjerg, Denmark.
Jesper Lykkegaard: Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Esbjerg, Denmark.
Marilena Anastasaki: Department of Social Medicine, School of Medicine, University of Crete, Heraklio, Crete, Greece.
Jette Nygaard Jensen: Department of Clinical Microbiology, Copenhagen University Hospital - Herlev and Gentofte Hospital, Copenhagen, Denmark.
Jens S��ndergaard: Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Esbjerg, Denmark.
Valeria Antsupova: Department of Clinical Microbiology, Copenhagen University Hospital - Herlev and Gentofte Hospital, Copenhagen, Denmark.
Davorina Petek: Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubliana, Slovenia.
Malene Plejdrup Hansen: Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Esbjerg, Denmark.
Marie Theut: Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Esbjerg, Denmark.
Christos Lions: Department of Social Medicine, School of Medicine, University of Crete, Heraklio, Crete, Greece.
Lina Jaruseviciene: Department of Family Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Ruta Radzeviciene: Family Doctor Clinic, Klaipeda, Lithuania.
Helena Glasova: Department of Clinical Pharmacology, Faculty of Medicine, Slovak Medical University in Bratislava, Bratislava, Slovakia.
Jozef Glasa: Institute for Health Care Ethics, Faculty of Nursing and of Professional Health Studies, Office of Clinical Pharmacology, Hepatology, and Internal Medicine, Policlinic, Slovak Medical University in Bratislava, Bratislava, Slovakia.
Nina Sodja: Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubliana, Slovenia.
Ana Moragas: Primary Care Research Institute Jordi Gol (IDIAP), Barcelona, Spain.
Ramon Monf��: Primary Care Research Institute Jordi Gol (IDIAP), Barcelona, Spain.
Ana Garc��a-Sangen��s: Primary Care Research Institute Jordi Gol (IDIAP), Barcelona, Spain.
Anna Kowalczyk: Centre for Family and Community Medicine, The Faculty of Health Sciences, The Medical University of Lodz, Lodz, Poland.
Georg Ruppe: Austrian Interdisciplinary Platform on Ageing/OEPIA, Vienna, Austria.
Laura Vallejo-Torres: Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, Las Palmas, Spain.
Marina Elistratova: Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, Las Palmas, Spain.
Beatriz Gonz��lez L��pez-Valc��rcel: Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, Las Palmas, Spain.
Greta Tsoulchai: Department of Social Medicine, School of Medicine, University of Crete, Heraklio, Crete, Greece.
BACKGROUND: Nursing home (NH) residents are frequently treated with antibiotics for urinary tract infections (UTIs), often due to overdiagnosis. The aim of this study was to evaluate the proportion of potentially unnecessary antibiotic use for suspected UTIs in NHs across eight European countries. RESEARCH DESIGN AND METHODS: Over a three-month period (February to April 2024), NH professionals recorded information on all antibiotic treatments for UTIs using a specific registration chart. Based on medical literature and the expertise of the project consortium members, the authors developed and endorsed by consensus a simplified algorithm to assess unnecessary antibiotic use in residents without indwelling catheters. RESULTS: The study, conducted across 110 NHs, included 2773 antibiotic-treated infections. Of these, 1158 (41.8%) were treated for UTIs. Among 975 UTI cases without catheters, 54.1% may have been unnecessarily treated. Over one-third involved nonspecific symptoms including poor general condition and changes in urine appearance, while specific urinary symptoms, such as incontinence (21.3%) and dysuria (20.8%), were less common. A trend toward greater, potentially unnecessary antibiotic use was observed when urine dipsticks were performed. CONCLUSIONS: The findings reveal potentially unnecessary antibiotic use. Further algorithm validation is needed to enhance diagnostic criteria, reduce overuse, and improve UTI management in NHs.
